A sexual health quality improvement program (SHIMMER) triples chlamydia and gonorrhoea testing rates among young people attending Aboriginal primary health care services in Australia

BMC Infectious Diseases

Research Article

Julie Booker¹  Debbie McCowen¹  Patricia Bullen¹  Chris O’Brien¹  Kristine Garrett¹  John M. Kaldor²  Rebecca J. Guy²  Handan C. Wand²  Janet Knox²  Simon Graham³  Basil Donovan⁴  James S. Ward⁵ 

[1] Aboriginal Community Controlled Health Service, Sydney, New South Wales, Australia;Kirby Institute, UNSW Australia, Sydney, Australia;Kirby Institute, UNSW Australia, Sydney, Australia;Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Australia;Kirby Institute, UNSW Australia, Sydney, Australia;Sydney Sexual Health Centre, Sydney Hospital, Sydney, Australia;South Australian Health and Medical Research Institute, Adelaide, Australia;

关键词: Aboriginal People;    Torres Strait Islander;    Quality Improvement Program;    Primary Health Care Centre;    Chlamydia Testing;   

DOI  :  10.1186/s12879-015-1107-5

 received in 2015-01-14, accepted in 2015-08-19,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn Australia, chlamydia is the most commonly notifiable infection and over the past ten years chlamydia and gonorrhoea notification rates have increased. Aboriginal compared with non-Aboriginal Australians have the highest notifications rates of chlamydia and gonorrhoea. Regular testing of young people for chlamydia and gonorrhoea is a key prevention strategy to identify asymptomatic infections early, provide treatment and safe sex education. This study evaluated if a sexual health quality improvement program (QIP) known as SHIMMER could increase chlamydia and gonorrhoea testing among young people attending four Aboriginal primary health care services in regional areas of New South Wales, Australia.MethodsWe calculated the proportion of 15–29 year olds tested and tested positivity for chlamydia and gonorrhoea in a 12-month before period (March 2010-February 2011) compared with a 12-month QIP period (March 2012-February 2013). Logistic regression was used to assess the difference in the proportion tested for chlamydia and gonorrhoea between study periods by gender, age group, Aboriginal status and Aboriginal primary health service. Odds ratios (OR) and their 95 % confidence intervals (CIs) were calculated with significance at p < 0.05.ResultsIn the before period, 9 % of the 1881 individuals were tested for chlamydia, compared to 22 % of the 2259 individuals in the QIP period (OR): 1.43, 95 % CI: 1.22-1.67). From the before period to the QIP period, increases were observed in females (13 % to 25 %, OR: 1.32, 95 % CI: 1.10-1.59) and males (3 % to 17 %, OR: 1.85, 95 % CI: 1.36-2.52). The highest testing rate in the QIP period was in 15–19 year old females (16 % to 29 %, OR: 1.02, 95 % CI: 0.75-1.37), yet the greatest increase was in 20–24 year olds males (3 % to 19 %, OR: 1.65, 95 % CI: 1.01-2.69). Similar increases were seen in gonorrhoea testing. Overall, there were 70 (11 %) chlamydia diagnoses, increasing from 24 in the before to 46 in the QIP period. Overall, 4 (0.7 %) gonorrhoea tests were positive.ConclusionsThe QIP used in SHIMMER almost tripled chlamydia and gonorrhoea testing in young people and found more than twice as many chlamydia infections. The QIP could be used by other primary health care centres to increase testing among young people.

【 授权许可】

CC BY   
© Graham et al. 2015